A review of venous thromboembolism risk assessment models for different patient populations: What we know and don’t!

Abstract

Venous thromboembolism (VTE) is a common cause of morbidity and mortality in hospitalized patients. Globally, it is also the third leading vascular disease, after myocardial infarction and stroke. The incidence of VTE is reportedly higher in Western countries than in Asian countries. However, recent reports suggest an increasing incidence of VTE in Asian countries, including India. Since VTE is largely a preventable disease, early identification of risk factors can lead to disease prevention or the adoption of appropriate prophylactic measures. To this end, several VTE risk assessment models (RAMs) have been developed and validated for different populations who are at risk of developing VTE, such as hospitalized patients with medical illness/surgical indication, patients with cancer, and pregnant women. Evidence indicates that the systematic use of RAMs improves prophylaxis rates and lowers the burden of VTE. Given the increasing burden of VTE in the Indian population and poor prophylaxis rates, the implementation of systematic RAMs in routine clinical practice might ameliorate the disease burden in the country. We have assessed the evidence-based utilities of available RAMs and have delineated the most common and suitable RAMs for different populations including coronavirus disease 2019 affected patients. This review depicts the current status of implementation and validation of RAMs in the Indian scenario. It also highlights the need for additional validation studies, improved awareness, and implementation of RAMs in clinical practice for lowering the burden of VTE.

Caprini versus Padua venous thromboembolism risk assessment scores

“…Caprini RAM outperformed Padua RAM in terms of sensitivity, PPV, and NPV, in consistency with the results of earlier investigations, which reported that the Caprini RAM was more accurate than the Padua RAM at making predictions. 20 , 26 , 27 In the present study, risk factors such as older age (age >70 years), previous VTE, reduced mobility, acute infection, and low or high Caprini score classification were significantly higher in VTE patients than in non-VTE patients. This result is in accordance with the findings of Kupelian et al 28 and Alabdulkarim et al 29 Therefore, it appears that the additional evaluation parameters in the Caprini RAM could account for its greater accuracy compared with the Padua model, and the low sensitivity of the Padua RAM for VTE could be related to the fact that many patients with multiple high risks were undervalued in that model.…”

“…Whereas the Caprini model is more widely used in surgical patients, the Padua model caters specifically to medical patients. 20 Both models have their strengths and limitations, and their selection should be based on patient population and clinical context. Despite a large proportion of hospitalized patients appearing to be at high risk for the consequences of VTE, thromboprophylaxis is still not adequately carried out.…”

“… 37 The Caprini RAM is widely used in various countries for assessing VTE risk, including in surgical patients. 20 Although specific studies that evaluate the Caprini model’s utility in SA are lacking, the fundamental risk factors (for example, age, comorbidities, and surgery type) remain relevant in this context. It is essential to consider the prevalence and impact of risk factors specific to the Saudi Arabian population, such as genetic predispositions, lifestyle factors, and cultural practices, which may influence VTE risk.…”

The Relationship of D-dimer Levels and the Incident of Deep Vein Thrombosis in Acute Ischemic Stroke Patients at Haji Adam Malik General Hospital Medan

“…35 This makes the method an effective tool in supporting DVT diagnosis. 36 This scoring method is considered a helpful instrument in diagnosing DVT, allowing for more precise subsequent steps, including administering anticoagulant therapy, by referring to established diagnostic algorithms. 37 In this study, it was found that all 21 respondents (100%) had asymptomatic DVT.…”

Risk factors for venous thromboembolism in hospitalized patients: A cross sectional study

“…Due to the lack of previous local studies of VTE in the study population, the prevalence of VTE in other studies of hospitalized populations is around 10-60% [19][20][21] .A pre-experiment was conducted by selecting a large number of quali ed individuals, with a margin of error of 10% and a signi cance level of 0.05, to estimate the VTE incidence rate of 25%. The required sample size was 1191 to ensure the accuracy of medical terminology.…”